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Medical Forum / General / Dentistry / May 2006How long should a filling stay tightly adhered?
Have an amalgam filling along the outer gumline on the lower left molar furthest to the rear. Was done August of '05, i.e. around 9 months ago. I haven't been completely happy with this filling from the beginning. Still quite sensitive to pressure if you touch it with a fingernail and extremely sensitive to cold liquid. I assume both are due to the depth of the filling, butting up against the nerve. I have another filling in the same place on the opposite site done by this same dentist about 12 years ago, never had these problems with it. Recently I noticed a slight "ridge" on the newer filling where the upper edge of the filling is no longer flush with the surace of the tooth. If I apply a bit of fingernail pressure, it moves back into place, so it tells me it's not tightly adhered to the tooth. That being the case, I assume I need to have it redone. However, it seems 9 months is a short period for a filling to need tending to. Surely this can't be okay for a filling? I'm concerned with material leaking in around it if it isn't tightly adhered. Assuming this does in fact mean it needs to be redone, would it be reasonable for the doc to do it at an extremely reduced rate or even without additional charge? I never thought to discuss a "warranty period". What's common for something like this? Or is it always "it lasts as long as it lasts"? Such a policy wouldn't seem to provide much incentive to get it right the first time. My whole reason for bailing out of the DMO and going with this guy is that I was under the impression he was more reputable. It's not like I haven't crossed this guy's palm with some coin. - Besides a couple of cleanings, exams and this filling, I've already popped for a root canal and crown with this guy due to what I believe was negligent care on the part of the DMO dentist - the decay that necessitated it occurred about 6 months after getting a filling in that tooth and despite quarterly perio maintenance cleanings with the DMO. That DMO dentist told me I needed the crown and I went to the other guy for a second opinion, and ended up giving him the work and leaving the DMO. I was damned if I was going to give the DMO hack another dime. Opinions? Thanks. As long as possible. I suspect the tooth was not prepared properly ..... state-of-the art-dentistry is now a BONDED composite, white filling ...... GET ONE before you need root canal therapy! Joel -- Joel34 > Have an amalgam filling along the outer gumline on the lower left molar > furthest to the rear. Was done August of '05, i.e. around 9 months ago. Are amalgams bonded? I don't think so. If it is loose then your dentist may not have placed it correctly. They use a doofer to squash it firmly into the cavity, no glue, just undercuts in the tooth to prevent it falling out. Oxidation/corrosion forms between the tooth and the amalgam which provides a "seal" of sorts, so they say. It's still poison. <snip> Well, amalgam can be bonded using a variety of techniques, if one so wishes. As for whether it's poison or not, you can find dangerous substances in every restorative material used in dentistry is you look hard. Regards, George > Well, amalgam can be bonded using a variety of techniques, if one so > wishes. Perhaps so but how often is that done? Not often i'll bet. > As for whether it's poison or not, you can find dangerous > substances in every restorative material used in dentistry is you look > hard. Well yes but Hg is particularly nasty and amalgams are known to leach Hg over the years so much so that most of the Hg is gone in 10 to 20 years. cheers > Regards, > George Well yes but Hg is particularly nasty and amalgams are known to leach Hg over the years so much so that most of the Hg is gone in 10 to 20 years. _______________________________ The miniscule amounts of Hg that can be released from finished amalgam are too small to alter the proportional content of the amalgam metal. When an old amalgam filling is measured for its content after 20 or 30 years, the compound still has Hg as its major component. The other components of the filling (Ag, Sn) simply would not stay in the shape of a filling without the Hg, in the same way that grains of salt would not stay in their shape without the chlorine. If you start with a solid amalgam mix that is half Hg and measure that filling 30 years later, it is still half Hg. - dentaldoc > Well yes but Hg is particularly nasty and amalgams are known to leach Hg > over the years so much so that most of the Hg is gone in 10 to 20 years. > _______________________________ > > The miniscule amounts of Hg that can be released from finished amalgam are > too small to alter the proportional content of the amalgam metal. You could be right. I was misinformed and have discovered on furtherreading that if only a few micrograms of Hg "evaporate" from say 5g of Hg in (for example) 10g of amalgam the fillings would still last thousands of years. > When an old amalgam filling is measured for its content after 20 or 30 > years, the compound still has Hg as its major component. The other > components of the filling (Ag, Sn) simply would not stay in the shape of a > filling without the Hg, in the same way that grains of salt would not stay > in their shape without the chlorine. yeah, amalgam is an alloy, salt is an ionic compound. > If you start with a solid amalgam mix that is half Hg and measure that > filling 30 years later, it is still half Hg. you might be about right. i will have to do some research on this subject. > - dentaldoc They can be but whay? Composite is a better solution today ...... and it answers unanswered health problems according to some ..... Unanswered questions about questionable unanswered amalgams ..... La .... la ..... fa ...... la.la ....... YOU WROTE, Are amalgams bonded? I don't think so. If it is loose then you dentist may not have placed it correctly. They use a doofer to squash i firmly into the cavity, no glue, just undercuts in the tooth to prevent it falling out. Oxidation/corrosion forms between the tooth and th amalgam which provides a "seal" of sorts, so they say. It's still poison -- Joel34 Hi Joel, How exactly are composites a better solution than bonded amalgam? Longitudinal studies have shown 70-90% survivability of amalgam restorations at 10 years, 50% survivability at 24 years. Hell, 24 years ago there weren't even decent composites to do posterior restorations. Even if you place a hybrid today on a posterior tooth, you can watch it wearing down and loosing all occlusal morphology within a few years; macrofilled are better but not by far. Now if you carve an amalgam and bring back the patient to polish it... you can see clear morphology year after year after year. Don't believe the hype. Composite is white and nice-looking, but its clinical properties have a long way to go before it reaches amalgam. Regards, George |
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